Research: other autoimmune diseases are more likely in MSers


Background: Additional
autoimmune diseases in people with MS and their
relatives have been studied many times. Studies have employed different
designs, and yielded conflicting results. 

Objective: We performed a systematic
review, and calculated overall risk of additional autoimmune diseases in
people with MS and their first-degree relatives. 

Methods: PubMed and Web of
Science were searched. Thyroid disease, diabetes, inflammatory bowel
disease, psoriasis, rheumatoid arthritis (RA) and systemic lupus
erythematosus (SLE) were studied. A generic inverse variance model was
used, and subgroup analysis was used to explore heterogeneity. 

Results: The odds ratio (OR) of
thyroid disease was increased in both people with MS (OR 1.66; p <
0.00001) and their relatives (OR 2.38; p < 0.00001). A similar
association was seen between MS and inflammatory bowel disease (OR 1.56;
p < 0.0001) and psoriasis (OR 1.31; p < 0.0001), although not in
relatives. There was no increase in the rate of either SLE or RA.
Studies examining diabetes showed significant heterogeneity and evidence
of publication bias. 

Conclusion: There is an increase in the rate of certain
autoimmune diseases in people with MS and their first-degree relatives.
However, this does not extend to all conditions studied. Given the
non-specific clinical presentation of thyroid disease, it should be
considered in all people with MS presenting with non-specific symptoms.

This is a study by Dr Ruth and Prof G, which indicates that MSers are more likely to also develop thryroid gland disease as well as inflammatory bowel disease and even psoriasis. Therefore it is perhaps of interest that thyroid disease occurs when the immune system regenerates after taking alemtuzumab. Therefore it is augmenting a natural tendency that is there. This suggests that there may be some common aetiological cause, but what is it?/What are they?

CoI: This study involved members of Team G

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  • Yes, this IS interesting.

    Especially, as HSP70 is also linked to thyroid diseases:

    "Stress has, for many years, been linked to the onset of autoimmune disease and, in particular, autoimmune thyroid disease (AITD). Whilst the exact mechanism of this association is unknown, it is clear that episodes of stress can induce profound changes in the immune system. More specifically, recent studies from several laboratories have shown an association between the expression of stress proteins and, particularly, the Hsp70 family with AITD. Our own studies describe a thyroid-specific Hsp70 which shares antigenicity with the key thyroid autoantigen, thyroid peroxidase."

    Also see my comment about the EBV-Stress hypothesis.

    Could HSP70 be the link between MS and Thyroid diseases?

    • I find it very plausible too, and had been stating it many times here because my MS (and probably other autoimmune diseases) had been preceded by periods of extreme stress and anguish. Very good to see the scientific theories behind it. Thanks for sharing.

  • In the CCSVI community, a possible link between thyroid and CCSVI has been suggested to involve venous congestion of the thyroid. If extracranial outflow is obstructed, collateral veins can run through the thyroid in the neck.

    From the autoimmune approach, in general, if a person has one autoimmune condition, aren't they at a higher risk to have a second autoimmune condition? It is just evidence of a more reactive/overreactive/autoimmune-prone immune system. But the article states this does not extend to all conditions studied. I would think that it would? So the question is not why IBS and psoriasis and thyroid disease, but why not all the other autoimmune diseases.

    • Possibly genetics; some genes that are associated with RA for example protect you from getting MS and vice versa. The idea that collateral veins run through the thyroid on their way to the heart and cause thyroid disease has no evidence to support it. Why would they traverse the thyroid. Some common sense and anatomy knowledge is needed.

    • The thyroid drains into the superior thyroid veins which drain into the internal jugular veins. Anatomically an outflow obstruction in the lower jugular would cause stasis or slowed flow in the superior thyroid veins? Can an inflowing superior thyroid vein become an outflowing vein from the jugular if needed? I don't have a medical background.

    • Do you have any thoughts on zonulin? As a disruptor of both the blood brain barrier and the intestinal barrier? It has no connection to jugular veins that I know of but if MS is a multifactorial disease, then there might be many factors that promote the development of MS.

    • Maren has in simple language explained that a valvular obstruction in the (left) jugular vein may lead to hypoperfusion of the thyroid gland (the incoming blood will be reduced as a result of the compromised outflow causing a suboptimal thyroid operation, aka hypothyroidism). The reason there is no evidence to support this is that the proposed jugular anomalies where just introduced in 2009 and ever since the global neurological community has done its best to bury the subject.

  • MD, it may come as a surprise to you, but vein abnormalities may occur elsewhere in the body. For instance, a compressed left renal vein can cause abdominal varicose veins, extreme abdominal pain, myelitis and even migraines.

    It's time you accepted that CCSVI is much more than a pair of blocked jugular veins.

  • I am interested in this because I have SPMS, Raynaud's and Multiple Nodular Goitre. Just had my 60th birthday so I expect to continue to be ignored by Neurologists…

By MouseDoctor



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